Category: Accessibility

Ending financial discrimination for cancer survivors: embedding the Right to be Forgotten in legislation across Europe

A new study published today in The Lancet Oncology highlights that many of the current 20 million cancer survivors across Europe are being discriminated against in accessing financial services, including loans, mortgages, health and travel insurance.

The work indicated that on average, up to 25% of those living beyond their cancer may be having more difficulty accessing appropriate financial services.

A European-wide effort is currently attempting to fight this discrimination, by supporting the introduction of legislation that will permit successfully treated cancer patients to not declare a previously diagnosed cancer, so that their diagnosis is essentially “forgotten”.
In January 2016, France became the first country in the world to introduce the “Right To Be Forgotten”, specifying that long-term cancer survivors do not have to share medical information with a financial institution about their cancer diagnosis after a delay of five years without recurrence. Seven other European countries have since taken similar legal measures to counter financial discrimination against cancer survivors. Other European Member States have chosen to implement self-regulatory codes of conduct (Denmark, Finland, Greece, Ireland, Luxembourg), but these are not legally binding.

With over eight years of experience, evidence from France indicates no significant negative impact on insurance companies operating in the French jurisdiction.

Those who are living beyond their disease should not be penalised for a previous cancer diagnosis. Cancer patients across Europe who have been successfully treated should, by law, be able to avoid disclosing a previous diagnosis of cancer, so that they can access the financial services that they need.

Professor Lawler added: “This is not about compassion; this is about evidence and acting on that evidence. When a cancer professional says that you are cured and international benchmarking agrees, then why do the financial institutions say that you are not? Don’t make cancer patients pay twice. Ensure the Right To Be Forgotten is enshrined in law throughout Europe.”

Read the full study here: https://lnkd.in/e_PZHn_j

It’s never been more important to focus on cancer prevention

With an ageing population, cancer cases predicted to increase from 17 million to 30 million by 2040 and rising levels of overweight and obesity, it’s never been more important to focus on cancer prevention. Over 40% of cancers could be prevented if we all lived healthy lifestyles, including maintaining a healthy weight, being physically active and eating a healthy diet.

But what does this mean in practice? Every day we’re bombarded with information about what’s healthy and what isn’t. It can be confusing and seem contradictory: what’s missing is the context – how do all the disparate pieces fit together to make a coherent picture?

That’s where our Global Cancer Update Programme, formerly known as the Continuous Update Project, comes in. This huge undertaking pulls the puzzle pieces together to show how what we eat, what we weigh and how active we are all affect our risk of cancer. The Expert Paneloverseeing the process then use that information to develop Recommendations for Cancer Prevention.

A while back I wrote about how this work was moving into a new and exciting phase of development. This new phase has now started and the programme has changed in a number of ways. It’s more:

  • targeted – looking at specific research questions such as early life exposures and their impact on cancer risk later in life.
  • collaborative – to increase the reach and scope of the work a number of collaborations with leading international research groups will take place that focus on specific areas such as dietary patterns and the life course.
  • efficient – we are shifting from reviewing all risk factors for every cancer to systematically scanning the evidence to identify which topics are likely to be the most fruitful areas of detailed study. Integrating more automation into the review process will be central to this.
  • inclusive – in addition to looking at cancer prevention, the work will expand to encompass cancer survivors. With improved diagnosis and treatment the good news is that there is a growing population of people living with and beyond cancer. The Global Cancer Update Programme will help us to understand how diet, nutrition and physical activity can improve long-term health and prolong survival after a cancer diagnosis.

There are four major themes to the work:

1. Cancer incidence

Looking at how a wide range of factors relating to diet, nutrition and physical activity as well as patterns of diet and lifestyle can affect cancer risk – either through decreasing risk or increasing it.

2. Cancer survivors

Focusing on the impact of diet, nutrition and physical activity on long-term health (cancer and non-cancer related morbidity, mortality and quality of life) after a cancer diagnosis. As part of this, we will look to determine for the first time the impact of diet, nutrition and physical activity on childhood cancer survivors.

3. Cancer mechanisms

Understanding the biological processes that underpin the links between diet, nutrition and physical activity and cancer.

4. Obesity

Ensuring previous work in relation to overweight and obesity remains up to date, given its critical role in increasing the risk of many cancer types. In addition, we will explore whether more specific guidance can be made for preventing obesity in adulthood and early life.

This comprehensive programme of work will allow us to look more deeply at how diet, nutrition and physical activity affect cancer risk and survival. In the next few years, the Global Cancer Update Programme will enable a more sophisticated understanding, with a more personalised approach to cancer prevention and survival than ever before.

Find out more about our Global Cancer Update Programme

Consumer wearables could make ‘positive contribution to routine care’

Consumer wearables that measure heart rate and physical activity provide similar clinical value to standard hospital tests for atrial fibrillation (AF) and heart failure, new research has found.

The study, published in Nature Medicine, examined whether a commercially-available fitness tracker and smartphone could continuously monitor the response to medications, and provide clinical information similar to in-person hospital assessment.

The wearable devices, consisting of a wrist band and connected smartphone, collected a vast amount of data on the response to two different medications prescribed as part of a clinical trial called RATE-AF, funded by the National Institute for Health and Care Research (NIHR).

Researchers used artificial intelligence (AI) to help analyse over 140 million datapoints for heart rate in 53 individuals over 20 weeks.

They found that digoxin and beta-blockers had a similar effect on heart rate, even after accounting for differences in physical activity.

This was in contrast to previous studies that had only assessed the short-term impact of digoxin.

A neural network that took account of missing information was developed to avoid an over-optimistic view of the wearable data stream.

Using this approach, the team found that the wearables were equivalent to standard tests often used in hospitals and clinical trials that require staff time and resources.

The average age of participants in the study was 76 years, highlighting possible future value regardless of age or experience with technology.

Professor Dipak Kotecha from the Institute of Cardiovascular Sciences at the University of Birmingham and the lead author of the study said: “People across the world are increasingly using wearable devices in their daily lives to help monitor their activity and health status.

“This study shows the potential to use this new technology to assess the response to treatment and make a positive contribution to the routine care of patients.”

“Heart conditions such as atrial fibrillation and heart failure are expected to double in prevalence over the next few decades, leading to a large burden on patients as well as substantial healthcare cost.

“This study is an exciting showcase for how artificial intelligence can support new ways to help treat patients better.”

https://www.htworld.co.uk/news/wearables/consumer-wearables-could-make-positive-contribution-to-routine-care/

 

The evolution of customer care: AI and the Gen Z effect

With the coming of age of Gen Z—both as customers and new workforce entrants—customer demands are evolving. At the same time, generative AI (gen AI) is transforming how contact centers respond to these demands. Forward-thinking leaders must explore the latest trends, emphasize cohesive support strategies, and take actionable steps to enhance their customer care functions, addressing challenges such as service improvement, cost reduction, and sales function integration.

In this episode of McKinsey Talks Operations, host Daphne Luchtenberg sits down with McKinsey partners Brian Blackader and Eric Buesing. Listen in as they discuss the latest trends, the importance of a cohesive support strategy, and actionable steps contact center leaders can take to improve their customer care functions.

The following conversation has been edited for length and clarity. Dates and statistics correct at time of recording in May 2024.

Daphne Luchtenberg: Every time you buy a product or service, you start or build upon a relationship with the company that stands behind it. And when something goes wrong or you just need help, the ease with which you’re able to get the support you need can have a big impact on how you feel and whether you choose to continue the relationship. With the arrival of more communication channels than ever before and the onward march of gen AI, how should organizations be thinking about where to improve their customer care functions? Throw Gen Z into the mix—with perhaps surprising preferences about how they want to engage with companies today—and you’ve got a complex landscape to navigate.

I’m delighted to be joined today by two of the people behind our recent research, “Where is customer care in 2024?,” Eric Buesing is a partner in our Charlotte office, and Brian Blackader is a partner based in Düsseldorf.

Eric, what do contact centers look like at the moment, and what are the challenges that they are facing?

Eric Buesing: The customer care function of the contact center is currently in the spotlight more than ever before, discussed even at the board level. Contact center leaders face unprecedented pressure in various forms: operational pressure to be efficient and reduce costs, enhance the customer experience, manage employees in increasingly complex environments, and expand the contact center’s role to include more advisory or consultative selling to build loyalty.

Customer expectations aren’t getting easier. With more platforms available for sharing information, disgruntled customers can amplify their dissatisfaction more loudly and broadly.

Daphne Luchtenberg: Eric, what does good customer service look like in today’s contact centers? What should companies strive for?

Eric Buesing: I don’t know if there’s any one organization that gets it all right all the time. At its core, good service involves excelling in the moments that truly matter—those critical times when customers are most in need. In these moments, the goal is to delight them in a way that impresses, garners loyalty, and resolves their issues, while generally maintaining good service overall.

Good service is characterized by several key aspects: the ease of resolving issues, the accessibility of information, and the integration of communication channels so that every interaction contributes to a cohesive resolution process.

Brian Blackader: Adding to that, what good looked like a few years ago, especially during the pandemic, has changed. Back then, simply being available was often enough. Now, we’ve returned to fundamental principles like solving problems effectively and knowing the customer across different touchpoints. Expectations have risen; customers now expect not just solutions, but also personalized understanding and engagement.

Eric Buesing: Absolutely, Brian. The principles of, “Know me, know my issue, and understand me,” are easily said and very difficult to achieve. The organizations that manage to do well in this area invest considerable effort in understanding how to meet these expectations. It’s not a game you win. It’s a game you play. You’re always trying to get better.

Daphne Luchtenberg: It’s interesting to see leaders turning to gen AI tools across various business operations, particularly in business services and customer care. Could you elaborate on the potential for adopting these tools in these areas and how they might enhance the services you described?

Eric Buesing: We’re about 16–17 months into the era of gen AI being available to the wider public. From my perspective, gen AI promises significant disruption, particularly in service functions. I believe that it could reduce current phone volumes by 50 percent within five years. However, the initial progress has been slower than expected. Many believed that gen AI would quickly reduce call volumes and transform customer interactions, but that hasn’t been the case yet. Few organizations have implemented gen AI at a scale where its impact can be effectively measured, and it’s crucial to understand why.

Despite the technological advances, the need for human interaction remains critical, especially for empathy and connection. I do see gen AI playing a significant role in efficiently resolving complex customer issues. We’re likely to see an increase in interactions with chatbots and virtual voice assistants, which will provide quicker, more accurate responses. However, the moments that truly matter will still require a human touch.

Additionally, foundational elements such as data connectivity, data quality, and the technical systems needed to deploy these AI capabilities are also vital. It’s important to recognize that it’s never just tech; early strategic planning and implementation are key to leveraging these tools effectively.

Daphne Luchtenberg: Eric, considering we’re recording this session, could you discuss the role of recording live conversations and how this might enhance intelligence and optimize the call center experience in the future?

Eric Buesing: First, the concept of speech-to-text isn’t new; organizations have been recording conversations for years. However, there’s been a shift in expectations regarding the quality of insights derived from these recordings, moving toward what’s now often referred to as conversational or voice intelligence. This advancement is crucial as it helps organizations explore the root causes of customer calls. Generative AI plays a significant role here, particularly with the concept of multi-intent. This means recognizing that customer calls are complex and cannot be simply categorized as, for example, a “billing call” or a “policy inquiry.” Conversational intelligence enables organizations to understand the multiple reasons behind a customer’s call, which in turn helps in resolving issues more effectively and proactively sharing information across the organization to prevent future frustrations.

There’s potential to use customer care data beyond traditional confines, such as for improving product design or service delivery to reduce customer friction. This approach involves leveraging voice data more strategically than just for compliance and quality assurance.

Brian Blackader: Adding to Eric’s point, while many discuss using these insights for training models, the reality is that many organizations still have a basic understanding of why customers call. Often, the primary reason logged is simply the first option an agent selects from a dropdown menu. It’s vital to understand not just the primary reason for a call but also the second-, third-, fourth-, or fifth-level intent. This understanding is crucial for two reasons: it helps address root causes throughout the organization and enables more targeted training for agents on specific recurring issues, rather than a general overview of a category like billing. We can really be specific on the issue that they’re struggling with.

Daphne Luchtenberg: With the technological advancements in customer care, there’s also a growing need for new skills. Brian, could you expand on the talent challenges that customer care leaders are currently facing?

Brian Blackader: There are two main challenges that care leaders face regarding talent. First, in countries like Germany where I am, or even in the US, there’s a general labor shortage. This makes it difficult to recruit people who can handle increasingly complex issues, especially as simpler tasks become automated. The challenge is not only to find frontline talent but also to enable them to address these complex queries effectively, all while striving to provide excellent customer service amid rising expectations.

Second, the traditional customer care path, where an agent progresses to a team leader, and then to a business unit manager, has been effective for developing people managers for the past 25–30 years. However, this pathway doesn’t necessarily produce the specialized skills needed today, such as data scientists, engineers, or developers. Leaders need to consider how to attract individuals with these skills to the agent level, perhaps targeting students with backgrounds in these areas. Additionally, they must make roles in customer care appealing compared with opportunities in big tech and other industries, where demand for these skills is also high.

Daphne Luchtenberg: That’s interesting. Let’s talk more about the talent pipeline. As Gen Z matures into consumers and the workforce of the future, their perspectives and behaviors might differ from previous generations. I found your insights in the blog post “Why your kids aren’t calling you, but they are calling their bank” particularly interesting, where you noted that some expected trends aren’t necessarily holding true. Could you expand on that?

Brian Blackader: Our research revealed some surprising findings about Gen Z’s communication preferences with companies. Contrary to what might be expected, their behavior isn’t drastically different from millennials, Gen X, or even boomers. When facing an unsolvable problem, about 70 percent of Gen Z individuals prefer to make a phone call, a share similar to older generations. This preference changes when it comes to personal communications, such as contacting friends or family, where they favor texting or messaging apps. However, for serious issues with services like banking or telecommunications, they still turn to phone calls. This indicates that companies that can effectively resolve issues through voice bots and provide excellent experiences will likely outperform their competitors.

Eric Buesing: Adding to that, our research also touched on email preferences across different customer segments. Surprisingly, about 70 percent of customers still prefer using email to resolve issues, despite its decreasing popularity among organizational leaders. Leaders often consider email a challenging channel to manage because it’s hard to track and measure compared with phone or chat interactions. This creates a disconnect, as customers appreciate the asynchronous nature of email—it allows them to send a message at their convenience, while someone else works on the issue later. This discrepancy poses challenges for organizations as they plan future communication strategies.

Brian Blackader: Exactly, and there’s an additional layer to this when considering people’s preferences during work or school hours, where email is particularly favored for its convenience. Additionally, our work in financial services highlighted another unique aspect of Gen Z, especially in the premium segments. Unlike millennials, Gen Z individuals in these segments expect high levels of service, akin to what baby boomers expect. They view phone service as a justified expectation for the fees they pay, demanding quality assistance and a positive experience as part of their service package. This insight is crucial for businesses aiming to cater to this demographic effectively.

Daphne Luchtenberg: It seems like some aspects of customer service are evolving significantly, while others remain unchanged. What do you envision for the future of customer contact centers?

Eric Buesing: As I’ve noted before, I expect a significant shift toward self-service options, predicting that 50 percent of current phone volumes will transition to these channels within the next five years. This shift will likely be driven by improvements in how customer issues are addressed, enhancing interactions with chatbots and virtual assistants to a more meaningful level. Some enthusiasts even believe that virtual voice assistants will become more empathetic than humans, as they won’t carry frustrations from previous interactions. Looking ahead, I’m optimistic about the improvements in service quality. There’s a prevailing acceptance of mediocre service when people call in, often expecting delays and potentially unhelpful responses. However, I foresee a future where service excellence becomes a hallmark of distinguished brands, significantly influencing customer loyalty and brand preference.

Simultaneously, the importance of human interaction will not diminish, especially for critical service moments. If phone volumes reduce by half, the quality and impact of the remaining interactions will become more crucial. I envision a future where customer service agents evolve into “superagents” or “journey managers,” equipped with advanced tools to provide informed, accurate, and empathetic support.

Daphne Luchtenberg: That sounds promising. Brian, would you like to add anything?

Brian Blackader: To summarize, I believe that leading organizations will focus on three key areas over the next five to ten years. First, they will streamline resolutions and enhance self-service capabilities for simpler issues, leaving more complex matters to customer service. Second, echoing Eric’s point, these organizations will empower their agents—whom we might call super agents—with sophisticated tools that aid in resolving customer issues effectively, fostering loyalty, and delivering exceptional experiences, possibly even with minimal training.

Lastly, the concept of an omnichannel experience will be crucial. While this has been discussed for over a decade, truly successful organizations will offer a seamless customer experience across all platforms—whether in-store, over the phone, through chat, or even via underused channels like video, and potentially augmented or virtual reality for specific scenarios. This consistency will ensure that no matter how a customer chooses to interact with a company, the great ones will be able to make sure that that experience is consistent across all the different ways you might contact them.

Eric Buesing: Brian, I really appreciate the concepts of omnichannel and optichannel, which refers to using the optimal channel for resolving issues. Currently, customers face a confusing array of options—social media, YouTube, websites, apps, calls, chats, and more. It’s not transparent which channel is best for their needs, leading to random choices. However, with the optichannel approach, it will become clear to customers which channel is most effective for their specific issues.

Daphne Luchtenberg: So, this would also mean that customers will grow more sophisticated at selecting the right tools for their needs, correct?

Eric Buesing: Exactly. It boils down to whether it’s simpler to handle an issue ourselves or to call for help. As long as calling remains the easier option, that’s what people will choose.

Daphne Luchtenberg: We’ve discussed many important points today. Before we conclude, Eric, where should leaders look for inspiration as they move forward?

Eric Buesing: Leadership in this area really requires courage. I’m often underwhelmed when we are asked, “Hey, do you have a North Star vision? What do you want out of your customer care, your servicing function?” The answers are often very incremental: “I’d love to see a 5 percent improvement in this. I’d like our budgets to be down, our handle times to go down, and our customer satisfaction score to go up slightly.”

We need to think bolder than that. Being a courageous leader means having a plan and setting an aspiration that is difficult and makes people uncomfortable, and then seeing it through. It’s one thing to say, “Hey, we want to cut our volume by 50 percent.” It’s another challenge to actually go after it.

In many ways, it requires collaboration outside of the contact center. The contact center is the receiver of somebody else’s problem. There has been a breakdown somewhere else in the customer journey, either by a product that didn’t deliver, a service that didn’t meet expectations, or an experience that was subpar. That drives volume.

So how do we look upstream and tackle those issues? How do we bring together the organizations or business units within an organization that need to come together to resolve them?

Daphne Luchtenberg: Yeah, I love that. Brian, what do you think?

Brian Blackader: In my interactions with customer care leaders, I’ve noticed they typically align with one of two approaches. The first group is action-oriented; they want to start immediately and tackle tasks head-on. The second group prefers to strategize, aiming to develop a North Star vision and a detailed road map, as Eric mentioned. It’s crucial to combine both approaches.

Creating a North Star vision and a road map is essential to avoid merely making incremental changes and to thinking in the long term. This involves making necessary investments and managing change over time. However, it’s also important to recognize that presenting such plans isn’t new to boards, and there might be limited patience for long-term results. Therefore, I advise leaders to also focus on achieving quick wins. By demonstrating early successes, you can build credibility within the organization and show tangible progress.

Additionally, I want to emphasize the importance of voice communication. Despite advancements in technology like chatbots, many customers still prefer calling. If these calls go unanswered, customers might escalate issues to regulators. With today’s technology nearing the capability to automate voice interactions effectively, there’s a significant opportunity to enhance customer experiences through this channel.

Eric Buesing: Adding to Brian’s points, another aspect we briefly touched on is transforming the role of contact centers from purely service-oriented to also encompassing sales. While “sales” can sometimes be perceived negatively, it shouldn’t be feared. Customers expect a high level of service that not only addresses their immediate issues but also anticipates their needs. This could involve better use of current products or introducing superior ones. The contact center is uniquely positioned to not just solve problems but also to provide valuable advice and recommendations. This shift from aggressive selling to thoughtful consultation can significantly enhance customer satisfaction and loyalty.

Daphne Luchtenberg: Fantastic, Eric. I couldn’t have said it better myself. Thank you so much.

Here’s a few things that I loved about the conversation today to think about as we close: first, this idea that customer service and contact centers are not a game you win, but rather a game you choose to play. Secondly, that gen AI is changing that game, albeit not as quickly as we might have expected, including through ways such as voice automation. And finally, there’s no better place in the contact center to build and deepen customer relationships and to give them better experiences during those moments that really matter.

Πηγή: mckinsey.com

Kapa3 – Social Message for Public Awareness and Education on Cancer

The Kapa3’s social message for public awareness and education on cancer has gone viral! A powerful message that captures the attention of thousands of citizens daily on social media.

Continuing its successful effort to raise public awareness about the importance of social support and its impact on managing chronic illnesses, Kapa3 created a television and radio spot emphasizing the need for timely and appropriate social support from the right people—especially in an era where globalization and rapid lifestyle changes pose major challenges to healthcare professionals and the community in cancer management.

The spot, titled “Think of a Word That Starts with K”, engages and captivates thousands of citizens daily, with its reach steadily growing. This multifaceted social message was posted online as part of a campaign created by Kapa3 to inform and raise awareness. The message has already surpassed 100,000 views, reinforcing Kapa3’s mission: social support and guidance for cancer patients navigating the challenging path of their illness.

This initiative is a strong call to social responsibility, encouraging everyone to actively participate in the ongoing effort to support healthcare services, improve cancer patients’ quality of life, promote prevention principles, engage the public in health management, reduce human and financial costs, and highlight civil society as a positive driver for public-benefit actions.

A key prerequisite for all this is the establishment of a strong, supportive social, institutional, and legal framework that safeguards patients’ fundamental right to a life free from stereotypes and discrimination.

Notably, the spot, produced with a focus on promoting public health and social support, was approved by the Greek National Council for Radio and Television (ESR). Following the approval of its Special Three-Member Committee for Social Messages (Decision 207-09.11.2023), the spot was authorized for free broadcast on television and radio stations nationwide from December 1 to December 31, 2023.

The campaign was made possible thanks to the unwavering support of friends, partners, volunteers, and Kapa3 members under the guidance of A3, and has been promoted across Greece and online through the organization’s initiatives.

We are sharing it with you online so that it can be featured by local media, spreading the message that “Not only Cancer Starts with K, but also everything that can defeat it”, leading the way in public education and awareness.

According to Mattson (2011), building on definitions by Albrecht & Adelman (1987) and Gottlieb (2000), social support is defined as “a transactional, communicative process involving verbal and non-verbal interaction aimed at enhancing an individual’s perception of their ability to manage their problem, self-esteem, and sense of belonging.”

We sincerely thank you for your positive response and support.

Evangelí Bista
Head of Development and Operations, Kapa3
PhD(c), MBA, MSc, BSc
Mobile: +30 697 410 2934

September has been established as Childhood Cancer Awareness Month.

Childhood Cancer Awareness Month.

It is a rare disease, according to the Hellenic Society of Pediatric Hematology – Oncology (EEPAO), but with serious consequences for both patients and their families. A disease that can be defeated but often with painful and long-term efforts and serious immediate and delayed complications.

The numbers are indicative: 300-350 new diagnoses every year in Greece, 35000 throughout Europe with 6000 children dying due to cancer. The Pediatric Oncologists-Hematologists, Elena Solomou and Antonis Kattamis (Professor NKUA) report that in early 2020, the COVID-19 pandemic resulted in the research community turning to a new path of research approach.

In Lancet Oncology, the work of Sheena Mukkada and partners has shown that the scientific community is united for the common good at this difficult time.  This prospective study analyzed data from children and adolescents (<19 years) with cancer and COVID-19 around the world.  Typically, data from approximately 1500 patients from 131 hospitals in 45 countries, including patients from Greece, were used. 259 (19.9%) of the patients had a severe or critical infection, while 50 (3.8%) patients died.  Comparing the data with adults, mortality in adults with cancer is 28%, much higher than in children.

Childhood cancer must be a priority for any strategic planning of each country’s health system. These diseases in childhood are treatable, with overall survival at 80% in high-income countries. But when the right resources are lacking, such as in low-income and middle-income countries (where about three-quarters of the global number of childhood cancer is recorded),  only 20-30% of individuals have long-term survival. Delays in early detection, poor access to diagnostic services in the absence of full access to required cancer medicines, higher rates of comorbidity (e.g. malnutrition, infections and poverty) as well as refusal or abandonment of treatment are common, resulting in increased morbidity and mortality. All these factors result in lower survival rates and higher morbidity rates than in high-income countries.

The COVID-19 pandemic has exacerbated inequalities in access to each country’s health system despite efforts to tackle childhood cancer. With the mandate given by governments in the 2018 cancer resolution, the WHO, together with major international childhood cancer hospitals, set a goal of treating at least 60% of all children with cancer worldwide and reducing pain for all children.

The data from this study enable us to understand that during the pandemic there is a unique opportunity to develop and implement strategies tailored to specific health systems and to reduce inequalities in diagnosis and access to medication in children with cancer globally.

The scientific community makes concerted efforts to achieve high cure rates, with the best possible quality of life and the minimum possible long-term complications. Genetic and molecular biology are now the necessary element of diagnosis and treatment in a large part of neoplasms of children and adolescents. Personalized treatment, which will further increase the chances of cure for young patients, reducing immediate and ultimate toxicity, is a goal that may become a reality in the near future.

In this context, HSPHO has taken initiatives to strengthen cooperation between the oncology departments of the Territory and the recognition of our country as an equal member of European scientific organizations. It participates in international collaborative treatment protocols, thus ensuring access to innovative medicines and therapies under proper and organized supervision. Of course, the process of Greece’s full, equal access to each of these protocols comes at a high cost. Fortunately, however, in the long, arduous struggle of the children and their families, over the years, valuable helpers and supporters, associations and volunteers have stood by.

The understaffing of the Pediatric Hematology / Oncology Departments in medical, nursing and paramedical staff, the lack of public structures for targeted molecular tests, the lack of financial coverage of specialized tests and the difficulty of access to innovative medicines are problems for which we have repeatedly informed the competent bodies.

Each of us can help to the best of our ability! You can become a volunteer blood donor, or volunteer bone marrow donor, or help associations and organizations supporting children and their families, either through sponsorships or by donating some of his time.

Any effort to improve the care of children with cancer is welcome and important!

Learn more:

https://www.iatronet.gr/article/104037/paidiatrikos-karkinos-kai-pandhmia-covid19

https://www.iatronet.gr/eidiseis-nea/epistimi-zwi/news/52168/septemvrios-minas-efaisthitopoiisis-gia-ton-karkino-tis-paidikis-ilikias.html

Digital-in-Health: Unlocking the Value for Everyone

Digital technology can strengthen health systems, improve health financing and public health, and increase reach to underserved populations, according to a new World Bank report launched today. The report also finds that digital technology and data are especially helpful to prevent and manage chronic diseases, care for both young and aging populations, and prepare for future health emergencies and health risks triggered by climate change.

The report, Digital-in-Health: Unlocking the Value for Everyone, was launched today during the G20 Health Ministers Meeting in Gandhinagar, India. It presents a new way of thinking from simple digitization of health data to fully integrating digital technology in health systems: Digital-in-health. This means, for example, infusing digital technologies in health financing, service delivery, diagnostics, medical education, pandemic preparedness, climate and health efforts, nutrition, and aging.

The report also underscores that the successful use of digital technologies must be inclusive of all population groups, and ensure access to digital infrastructure, modern technologies, and skills, especially for vulnerable people.

“Designed with people at the center, digital technology can make health services more personal, prevent healthcare costs from increasing, reduce differences in care, and make the job easier for those who provide health services,” said Mamta Murthi, Vice President for Human Development, World Bank. “We hope that this report will give governments confidence and practical guidance, regardless of the country’s stage of digital maturity or fiscal challenges.”

Improving health is getting harder, not easier. Health systems face serious and growing challenges and policy decisions are too often not based on reliable data.  It is estimated that some countries use less than 5% of health data to improve health which means that decisions are not based on data or data is not used effectively to make improvements. Within challenging fiscal environments, people-centered and evidence-based digital investments can help governments save up to 15% of health costs. The report presents pragmatic, low-cost actions to improve digital-in-health, no matter the maturity of a country’s systems or digital infrastructure. For example, better health data governance and standards to ensure systems can readily connect and exchange information are not costly but will be game changing in reducing siloed digital solutions and fragmentation.

“In India, we have shown that digital innovations such as tele-consultations have reached more than 140 million people and provided accessible, affordable and efficient healthcare for everyone,” said Mansukh L Mandaviya, Minister for Health and Family Welfare, India. “We believe a digital-in-health approach can unlock the value of digital technologies and data and has the potential to prevent disease and lower healthcare costs while helping patients monitor and manage chronic conditions.” 

 

To help countries embrace a digital-in-health approach, the report proposes three essential areas to guide investments:

  1. Prioritizeevidence-based digital investments that tackle the biggest problems and focus on the needs of patients and providers.
  2. Connect the regulatory, governance, information, and infrastructure dots so that patients know that data is safe and health workers can use digital solutions transparently.
  3. Scale digital health for the long run based on trust with sustainable financing, and improved capacity and skills for digital solutions.

It will take global, regional, and country leadership to make digital-in-health a reality. The report recommends strong country leadership involving all relevant sectors and stakeholders, including civil society. Digital technology and data improvements will involve investments beyond the health sector and new partnerships with the private sector. A digital-in-health mindset needs to be a routine aspect of annual health system planning, budgeting, and implementation.

The World Bank is committed to helping low-and middle-income countries to make digital-in-health a reality to improve health for everyone. Over the past decade, the World Bank has invested almost $4 billion in digital health including in health information systems, digital governance, identification systems, and infrastructure.

For more information, including a copy of the new report, Digital-in-Health: Unlocking the Value for Everyone, please visit:

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New modern facilities of the non-profit organization KAPA3

With immense joy and pride, we announce that the non-profit organization Kapa3, with a mission to offer to people suffering from Cancer, will continue the creative and productive work from the new, modern offices at 13 Kostis Palamas Street, Athens.

Το ΚΑΠΑ3, is an organization that aims to support and inform people suffering from cancer, and their families, regarding their accessibility to the beneficial provisions of the current legislation, as well as the utilization of existing structures and services that operate for this purpose throughout the Greek territory. The organization and the members of the organization believe that people with cancer and their families should have access to accurate information at the time they need it. The organization’s website and the free kapa3 app (available on smartphone, tablet, Android, and iOS), operate as a guide to specific Rights and Benefits.

Improving the quality of life for Cancer patients is a top priority for the Kapa3 organization. A team of professionals supports patients in all procedural matters outside and inside the hospitals. The measurement of social impact had excellent results with 91% of patients stating that the presence of the service was instrumental in making their daily life easier.

The Movable Groups operate from the Theagenio Cancer Hospital of Thessaloniki and the University General Hospital of Alexandroupolis, covering the region of Macedonia – Thrace and beyond, while their aim is to improve the quality of life of oncology patients and to provide new prospects for social integration, social protection, and employment. Soon we will be able to announce new “Information and Management” groups.

The Movable Units started their work with the foundational donation of TIMA Public Benefit Foundation https://www.timafoundation.org/el/ which supports Greek non-profit organizations that contribute to social improvement with a focus on the Elderly.

Kapa3, in three years of operation, has employed more than 15 people, while it has been the first preference in the choice of graduates of social support professionals, in the context of their internship, resulting in the strengthening of the action groups and its network, with more than 25 students. In addition, it has proceeded to establish collaborations with Universities in Northern Greece and beyond, as well as with Research Laboratories of Medical Departments of Universities in the country and abroad, in an effort to improve and scientifically approach and document activities and services provided to cancer patients throughout the country..

On the basis of the activation of the organization’s new offices and according to the needs of its beneficiaries and employees, another step is taken to encourage the development and expansion of the organization’s network, through proper cooperation, flexibility, empowerment, trust, and equality. “The beneficiaries and partners of the organization find support at all levels and thus are encouraged to be the best version of themselves in an environment that is built based on the vision and mission of the organization”, said by, Ms. Bista Evangeli, Development and Operations Manager of Kapa3.“In an environment where each of us feels cared of, supported, and connected, with a strong sense of ownership, the organization’s growth is taken for granted,” she added.

In addition, Ms. Bista emphasized that the organization’s new offices are made possible with the valuable support of the company “THENAMARIS” which she thanked for its valuable assistance.

“The contribution to our community is at the forefront for the company, leaving a strong, continuous, and positive social footprint that meets the specific features and needs of Greek society. Moreover, the ability to respond to challenges, to anticipate and adapt to the “seas and storms” is a warranty of viability for us and an important partner in the work and contribution of Kapa3“, Ms. Bista concluded.

Cancer Effects on Caregivers and Work

A CANCER DIAGNOSIS RESULTS IN A LOT OF CHANGES for both the patient and the caregiver.

For the caregiver, those changes can include adjusting work schedules, which, in turn, can affect their finances.

The unexpected expense of cancer treatments coupled with the lack of paid leave can be a one-two punch to caregivers’ financial resources. “For many caregivers, keeping debt low or nonexistent may not be possible,” says Cathy J. Bradley, a health economics researcher and co-author of a study titled “Working, Low Income, and Cancer Caregiving: Financial and Mental Health Impacts,” published online April 12 in the Journal of Clinical Oncology. “The Federal Reserve reports that many households would have difficulty absorbing $400 in unexpected costs. Cancer treatments are among the most expensive treatments in the United States.”

In many instances, caregivers can take paid leave to care for their loved one, which can mitigate financial hardship, but that’s not always the case. Often, caregivers are faced with taking unpaid leave or having to stop working altogether—both of which negatively impact their finances.

According to Bradley’s study, 35% of cancer caregivers stopped working and 30% saw their household debt increase. Those in households earning less than the median household income were more likely to experience decreased income and stop work than peers in similar financial situations who were caring for people with conditions other than cancer.

“Data on reasons for stopping work was not part of this study, but we speculate that caregiving demands are greater for cancer patients,” says Bradley, an associate dean of the Colorado School of Public Health and deputy director of the University of Colorado Cancer Center. “We also speculate that lower-income households cannot pay for additional help so that the caregiver can continue working.”

A key element forcing caregivers to stop work is no paid leave at their workplace. According to the American Cancer Society Cancer Action Network (ACS CAN), studies show that cancer patients with paid leave have higher rates of job retention and lower rates of financial burden. However, 48% of caregivers report experiencing problems related to financial pressure caused by not being able to work or having to reduce work hours to care for their loved one.

“Cancer treatment is so all-consuming for the patient but also for the family and anyone who is caregiving for the patient,” says Jennifer Hoque, associate policy principal on access to care for ACS CAN. “And that includes all-consuming with finances and time. Time is money. The more time you have to spend caregiving for the cancer patient, the more potential for lost wages and other money you’re spending. And it’s not just time caring for the patient. It’s also transportation, taking the patient to and from their treatments. Sometimes it’s lodging because sometimes you have to stay overnight.”

To help cancer caregivers, ACS CAN supports legislation providing for paid leave in the workplace so everyone has access to it and can help their family members. The Family and Medical Insurance Leave (FAMILY) Act was introduced in Congress on May 17. If passed, it would provide workers with a maximum of 12 weeks of financial support during a family or medical leave from work. In addition, 11 states and Washington, D.C., have enacted paid leave laws.

Finding assistance is crucial for cancer caregivers. “Caregivers provide a tremendous service to their families and society at large with very few supports,” Bradley says. “As a result, they suffer not only physical and mental consequences, but they also suffer financial consequences that last for years. Lower-income households take on the greatest financial burden and may never recover.”

If you’re caring for a cancer patient, it’s important to find out what type of leave is available. For instance, the Family and Medical Leave Act currently in effect provides 12 weeks of unpaid leave during a one-year period. Although leave is unpaid, the law protects your job while you’re away from work. Also, find out how flexible your employer is in allowing remote work or changing your work hours for doctor appointments and treatments.

Other assistance may be available through local, state and national programs such as the CancerCare Co-Payment Assistance Foundation, HealthWell Foundation, and the Leukemia & Lymphoma Society. Patient navigators at your loved one’s hospital or cancer treatment center can also be a valuable resource in advising you about financial assistance.

Cancer Effects on Caregivers and Work

Quality Questions:When you are diagnosed with cancer, how can you be sure you’re getting appropriate care?

IN APRIL 2020, truck driver John Lex was waiting to load up his tractor trailer at a Walmart distribution center in LaGrange, Georgia, when he felt a severe, sharp pain in his lower abdomen. The self-proclaimed “stubborn guy” figured if he went home to lie down, he would feel better. However, by the time he arrived home in Monroe, Georgia, the pain had amped up to “an eight out of 10.” He asked his wife to drive him to the local hospital’s emergency room.

Doctors there thought his pain might be appendicitis, but a CT scan revealed something unexpected: a mass in his colon. “The doctor told me that they believed it was cancerous, but he wouldn’t know for sure until they got in there,” says Lex, now 56, who had immediate surgery to remove the mass and have his colon resected. He would need to wait for results from the biopsy to get confirmation, but “[the doctor] was pretty confident that it was cancer,” Lex says

Three days after surgery, on April 25, 2020, these suspicions were confirmed. Lex’s tumor was malignant—with 19 positive lymph nodes. He had stage IIIC colon cancer. He was referred to a medical oncologist at Piedmont Walton Hospital in Monroe—the same hospital where he had his surgery. He completed a six-month course of chemotherapy with FOLFOX (folinic acid, fluorouracil and oxaliplatin), but in January 2021, the scans showed that the tumors were back in his colon, as well as the lining of his abdominal cavity.

At that time, his oncologist suggested another chemotherapy combination and referred Lex to a colleague at Atlanta-based Winship Cancer Institute at Emory University, which is less than 30 miles away from Lex’s home, for a second opinion. Winship Cancer Institute has earned the National Cancer Institute’s highest honor—a comprehensive cancer center designation—which signifies significant research infrastructure along with the capacity to provide high-quality treatments to patients. The oncologist at Winship confirmed the treatment plan. Lex continued to be treated by his original oncologist, satisfied that he was receiving appropriate care.

Treatment Close to Home

Like an estimated 80% to 85% of people with cancer in the U.S., Lex sought treatment at a community cancer center. Community cancer centers typically provide care through oncology practices or networks, offering treatment at local hospitals instead of specialty cancer centers. They are not usually a part of large academic teaching hospitals and don’t have NCI designations.

“Community hospitals are those institutions that are designed to take care of patients. They’re not necessarily teaching and they’re not necessarily doing research. That’s not to say that they never do,” says Thomas Tucker, the senior director for cancer surveillance and associate director of the Kentucky Cancer Registry at the Markey Cancer Center Prevention and Control Program at the University of Kentucky in Lexington. Tucker has published research on Markey Cancer Center’s efforts to form an alliance with community cancer hospitals to help provide more standardized cancer care throughout Kentucky.

The decision to receive care in a community cancer center is often influenced by geography, given that many people in the U.S. do not live near large academic teaching hospitals or one of the 71 NCI-designated cancer centers spread across 36 states and the District of Columbia. “The number one criterion that’s going to affect where a cancer patient gets treated is going to be their location,” says Rose Gerber, a breast cancer survivor who is the director of patient advocacy and education at the Community Oncology Alliance, a nonprofit organization based in Washington, D.C., that advocates for the preservation of oncology private practices that offer patients high-quality, affordable cancer care close to home. Gerber notes referrals often come from a patient’s primary care doctor who is familiar with local oncologists. In addition, a patient’s and doctor’s familiarity with the local health system and the convenience of not traveling far for what are usually multiple treatments often provide reassurance to patients, Gerber says

Experience Matters

Other variables, including a person’s cancer type, stage, the pathology and genetic makeup of the tumor, and any previous treatments, can all factor into people’s decisions about where they go for their care. When analyzing choices, oncologist Diane Reidy-Lagunes suggests that patients start by asking questions to gain an understanding of the doctor’s experience with the patient’s stage and type of cancer.

“There are definitely some questions that you want to ask the oncologist when you’re meeting them … particularly for instances of rare diseases,” says Reidy-Lagunes, who is the associate deputy physician-in-chief of the Regional Care Network at Memorial Sloan Kettering Cancer Center in New York City. She suggests asking, “Is this a disease that you’re often taking care of? Have you only seen one in your lifetime or do you see five in clinic daily?”

Patients can also look up a physician’s specialties online before the office visit, says Nancy Keating, a primary care physician at Brigham and Women’s Hospital and a researcher in the Department of Health Care Policy at Harvard Medical School in Boston, who studies factors that influence the delivery of high-quality care for people with cancer. “The more specialized training someone has, the better, especially when complex care is needed,” she says, using the example of a surgeon who specializes in a certain kind of cancer. “If you are a colorectal surgeon, you’ve done a fellowship, and you only do colorectal surgery. In addition, you are continually getting exposed to new cases daily and that’s all you do.”

With more experience comes greater proficiency. Research indicates that people with cancer who undergo complex procedures at high-volume surgical centers have better outcomes compared to low-volume centers, including for lung, esophageal and pancreatic cancer. For example, one study published in the April 2017 Annals of Surgery suggests patients with esophageal cancer who traveled to high-volume surgical centers had significantly better five-year survival rates, with 39.8% of patients living five years or longer compared to 20.6% who sought treatment at low-volume surgical centers. Another study published Nov. 1, 2021, in Cancer, compared outcomes at high-volume and low-volume radiation centers for a number of cancers and found patients receiving adjuvant radiation had significantly improved survival at very high-volume facilities when compared to low-volume facilities. Patients who received radiation alone for prostate, non-small cell lung, pancreatic, and head and neck cancer without surgery or other treatments also had increased survival, according to the study.

Lindsay Longo, an IT services director who lives in Tampa, Florida, was diagnosed with stage II Hodgkin lymphoma in November 2020 after going to an emergency room with escalating symptoms from COVID-19. While she was there, doctors performed a CT scan and discovered a large mass in her left lung, a rare presentation of Hodgkin lymphoma. She had a lung biopsy on Nov. 25, 2020, and five days later was diagnosed with cancer.

Longo ultimately decided to get her treatment at Moffitt Cancer Center, an NCI-designated cancer center in Tampa. The 39-year-old was impressed with the depth of experience that Moffitt provided, including swift coordination of care. “I didn’t feel like [the hospital where I was diagnosed] was moving fast enough for me, so I decided on Moffitt for its credibility and the top ranking. For me, it was a no-brainer,” she says.

On Dec. 31, 2020, Longo began treatment, receiving eight rounds of ABVD (Adriamycin, bleomycin, vinblastine, and dacarbazine) administered every two weeks. At the end of treatment, a scan revealed one spot on a lymph node. At that point, a tumor board, consisting of a multidisciplinary team of physicians at Moffitt, reviewed her case and suggested she have four more rounds of chemotherapy. On July 27, 2020, her scans were clear.

Access to Clinical Trials

While the standard-of-care treatments offered in cancer centers and community hospitals already have proven efficacy, some patients may also be interested in experimental treatments and clinical trials, says Gerber, who was diagnosed with stage II HER2-positive breast cancer in 2003.

Gerber had a lumpectomy followed by eight rounds of chemotherapy and radiation at Eastern Connecticut Hematology and Oncology, an oncology practice affiliated with Backus Hospital in Norwich, Connecticut. Her physicians also offered her an opportunity to participate in a clinical trial that tested the use of a targeted medication called Herceptin (trastuzumab) to reduce the chance of her cancer returning.

“[HER2-positive breast cancer] at the time was one of the deadliest diagnoses with a very poor prognosis,” she says. Gerber realizes now how fortunate she was to take part in a ground-breaking clinical trial. Today, she credits her survival and good health to being a part of the Herceptin clinical trial, and the drug is now the standard of care for patients with HER2-positive breast cancer. Gerber notes that many community cancer centers offer clinical trials—and the idea that this type of research is only offered at larger research or academic hospitals is a misconception.

Having access to a range of treatment options—both the standard of care and experimental drugs—is especially important for patients who have advanced cancer, says Heidi Nelson, medical director of the American College of Surgeons, Cancer Programs, which is responsible for the Commission on Cancer (CoC) accreditation program for hospitals. The accreditation means facilities have demonstrated that they provide a range of services, either on-site or through referrals to other facilities, including diagnostic imaging, radiation oncology, systemic therapy, psychosocial support, rehabilitation, nutrition and access to clinical research.

Collaboration between medical oncologists, surgeons, radiation oncologists, nurses and social workers provides a good measure for quality care, Nelson says. “With an appropriate team of specialists, each professional sees a different part of the patients’ needs and the cancer details. The full picture comes together when all the professionals come together around each patient to make sure nothing is left out of the care plan,” she says.

That type of collaboration can also extend across hospital systems—including between NCI-designated cancer centers and community hospitals. One example of this type of collaboration is with the NCI-designated University of Kentucky Markey Cancer Center, in Lexington, which started an affiliate program in 2006 that now includes 21 community hospitals. One of the requirements for facilities taking part in the alliance is achieving and maintaining CoC accreditation, as a means to increase quality of care in cancer hospitals across the state. A study of 13 hospitals in the network published in the February 2021 Annals of Surgical Oncology showed this collaboration increased the hospitals’ ability to meet quality measures three years after they joined the network compared to three years prior. In addition, the number of hospitals that received CoC accreditation increased from three to 12.

“This is an opportunity for the medium- and small-sized hospitals to have access to resources for facing issues or problems they may not have seen before,” says Tucker, who notes that academic and research hospitals don’t have the capacity to treat every cancer patient. “The smart thing [to do] is to help community hospitals develop that capacity. Many of them are quite good at it [already],” he says.

For patients like Lex, having the ability to tap into expertise at both his local cancer center and a larger cancer center provided extra reassurance. This collaboration included having a multidisciplinary team review his case at the hospital to determine the best course of care. “Knowing that it’s not just [my oncologist] that’s looking at my records, that it’s all the doctors that she works with really eased my mind,” he says.

In May 2021, Lex went back to Winship for another second opinion after a PET scan showed one of his three tumors was growing. Genetic testing in early 2021 showed his tumors tested positive for BRAF mutations, which made Lex eligible for a combination of targeted therapies, Erbitux (cetuximab) and Braftovi (encorafenib). Since starting treatment, his tumors have appeared to be less active in the PET scans, which could be an indication that treatment is working. In addition, one tumor has gotten smaller in size. He hopes the targeted therapy will keep his tumors at bay. “We’re hoping that maybe the treatment will knock it out completely,” says Lex. “I am so happy I got the second opinion. It just eases your mind because I have two great doctors looking over me.”

Quality Questions